Drug interactions
Clarithromycin + Ifosfamide
Severity: Moderate
Clarithromycin and Ifosfamide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ifosfamide is a prodrug activated by CYP3A4, but is also converted to neurotoxic and nephrotoxic metabolites by the same enzyme. Clarithromycin may therefore alter the balance of active and toxic metabolites and potentially reduce efficacy, although the clinical effect is not well defined.
What this interaction means in plain words
Clarithromycin and Ifosfamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clarithromycin belongs to Anti Bacterial; Ifosfamide belongs to Oncology.
Why it happens
Clarithromycin inhibits CYP3A4, changing the bioactivation of ifosfamide and its metabolite profile.
What to do
Prefer a non-CYP3A4-inhibiting antibiotic during ifosfamide cycles; if unavoidable, monitor for reduced response and for neurotoxicity.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Clarithromycin with Ifosfamide?
MediHelp rates the interaction as moderate. Clarithromycin and Ifosfamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ifosfamide is a prodrug activated by CYP3A4, but is also converted to neurotoxic and nephrotoxic metabolites by the same enzyme. Clarithromycin may therefore alter the balance of active and toxic metabolites and potentially reduce efficacy, although the clinical effect is not well defined.
How serious is the interaction between Clarithromycin and Ifosfamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-CYP3A4-inhibiting antibiotic during ifosfamide cycles; if unavoidable, monitor for reduced response and for neurotoxicity.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
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